The movie character Ricky Bobby became a NASCAR driver when he indicated that he wanted to go fast.

In veterinary and in human medicine, ER teams may "go FAST ") when a pet (or person) has trauma in the abdomen or chest.

The FAST (Focused Assessment via Sonogram for Trauma) scan is an exam done using an ultrasound that looks for bleeding in a body cavity. It is a very fast, relatively simple technique that gives good information about trauma patients.

At the recent IVECCS international conference, I received training on FAST scans so that we may use Pet Emergency Clinic's ultrasound machine to better help your injured pet.

At the conference, I learned about A-FAST (abdominal FAST), T FAST (Thoracic or chest FAST), and vet BLUE (Bedside Lung Exam with Ultrasound), which are all used together to asess just how hurt a hurt pet is.

Did you know that CPR stands for Cardio Pulmonary Ressussitation, which is the life-saving action taken after a patient, human, or animal, either stops breathing or has a stopped heart.

Many of you are probably Red Cross certified on humans, so I am sure that you can imagine that the procedure is also used on animals.

For the past several years, a large group of veterinary Cardiology end ER experts have been working to study CPR techniques and to determine just what actions work, and which don't. They recently came out with recommendations for veterinary CPR that attempt to standardize CPR and the actions that WORK.

At the recent International Veterinary Emergency and Critical Care Symposium (IVECCS) in Indianopolis, I was trained in the new techniques. I am now helping our doctors and staff utilize the new actions to give your sick pet the best chance.

A couple of interesting points...

CPR " pumps" on the heart of a dog or cat should be done about 2 per second. If you pump to the tne of the BeeGees song "Staying Alive", you will be about right.

Though "mouth to mouth" has been somewhat de-emphasized in human bystander CPR, breathing is still key in animal CPR. with quick breaths every 6 seconds considered good.

Regarding CPR success: When a pet or person with severe illness involving multiple organ systems arrests, success of CPR is usually very low.

But when a pet has a sudden problem, such as an arrest during anesthesia, the success of CPR is MUCH MUCH higher.

Just wanted you to know a little more about your pet's emergency care.

So, I suppose you could say that we veterinarians are all teachers in some sense of the word. While most of us do not attempt to teach a large bunch of active children in a formal classroom, we definitely teach and explain pet disease and preventive care to clients one at a time.

Of course, it is important for any teacher to have the latest data to teach in order to get a good product.

I was fortunate to spend most of last week at the International Veterinary Emergency and Critical Care Symposium in Indianapolis. Along with about 2000 fellow ER veterinarians from all over the world, I was instructed in the latest in ER veterinary medicine. My approximately 30 classroom and lab hours, were extremely rewarding, and all of the new updated materials presented were very exciting.

There are more than I can begin to list, but some of the new info I brought back to better help your pets include the following:

CPR- when a pet has a cardiac arrest, it is always a difficult situaton. But the latest standardized methods may improve results and give your CPR pet a better chance.

Heart Disease Emergencies- There are a few new improved handlings for pets with heart disease on emergency that we will be using.

Pet Nursing Care- The latest on caring for very sick pets in-hospital was presented and we will put it to use.

Pet Seizures- Learned new information about pet seizure medicine that will help these distressed pets.

Disc disease- the latest update on treatments that will help dogs with injured backs that may result in paralysis.

Ultrasound in trauma- There are new ways that this cool machine is able to help injured pets. The presenter of this course is actually teaching human physicians similar techniques for use in the human ER.

We at Pet Emergency Clinic are committed to bringing you, the awesome pet owner, the best we can give you. The above should help to do that.

As you know, our pet dogs and cats have a 4-chambered heart similar to a human's.

The heart is a very important pump charged with circulating blood through the body in an endless loop. The left side of the heart accepts oxygen-filled blood from the lungs and pumps it through the body to each organ. Once the red blood cells drop off a load of oxygen, they are routed through veins back to the right side of the heart. Now the right heart pumps the oxygen-less red blood cells into the lungs to pick up another load of oxygen. They proceed again to the left heart to again be pumped to the organs, and to the right heart to the lungs, etc., etc. [To you physiology buffs, sorry. I know this leaves out lots of what is also happening. But is gives the general idea]

So, it makes sense that the heart pump must work, and work correctly, for the animal to have a good life.

Humans are most often concerned with blockage to the blood vessels that provide oxygen to the heart ("heart attack"), but many other problems may occur.

Dogs and cats do not often get "heart attacks," but they do have other problems. Usually in small breed dogs, valves within the heart have problems and render the pump very inefficient. In large dogs, more often the actual muscle that makes up the heart has problems.

In some dogs, the electrical signal that controls the heart beat gets off. The ECG test evaluates this electrical signal and based on an ECG, we may know how to correct some problemst. It is interesting to note that a pet with severe heart disease may have a normal ECG, and some pets with a terrible ECG tracing show no apparent symptoms.

So what should you know to help your pet?

Know the signs of heart problems. These include weakness, laziness, getting tired very easily, and in some cases turning blue and or collapse. In some pets, you may feel a vibration in the chest. (This is called a "thrill.") You may find that at first, symptoms come and go. Later, they may come and tend to stay.

What to do if you see anything that concerns you about your pet's heart?

As usual, go see a veterinarian and get it checked out. The usual approach is to perform a good physical exam, an ECG, and a chest X ray. Blood testing may be done, and there is a somewhat new test called a bNP that may actually help diagnose heart disease in cases in which we are not certain.

Another valuable tool is ultrasound, called an ECHOcardiogram.

With the above information, if your pet is diagnosed with heart disease, your DVM can start the pet on medicine, diet, and exercise programs to improve things One thing to realize is that, eventually, the heart disease will likely overcome the pet.

So, just like with humans, moderate exercise, healthy eating, and good preventive care can help reduce the threat of heart disease.

If you see what you believe may be heart symptoms in your pet, see a DVM. Do not wait. During hours, your own DVM. And after hours, Pet Emergency Clinic.

Recently, I treated a pet that had been seen by DVM's for illness 4 times in the previous week. The symptoms were vague, but included some vomiting, some diarrhea, and some intermittent weakness. I had a suspicion, and convinced the owners to allow me to run fresh blood testing inluding electrolytes a long with a new X-ray.

To make a long story short, the blood testing was highly suspicious of a disease called Addison's disease, in which the body does not produce enough natural cortisone. These animals tend to have vague symptoms and to "wax and wane." The electrolytes collected at the time of weakness gave me the answer.

The very nice pet did well with IV fluids and a small amount of cortisone. Incidentally, natural cortisone is required by the body as an answer to stress. The body may do well without it until stress occurs, at which point the body gets very weak.

I mention this not to extol my virtues as a diagnostician, but to point out that TIMELY testing when the symptoms are present is very valuable.

I had another case in which a six month old puppy presented for tremors after the owner had treated it with an OTC flea product that often causes tremors. I recommended some simple lab testing, which the owner declined, and I treated the symptoms the best I could.

Several days later, the owner called, angry because several days later, the dog broke with Parvo virus, which he felt should have been diagnosed at the ER. I explained to the owner that, in the absence of laboratory testing, a doctor is truly "flying blind," treating based on history, physical exam, and symptoms only. (I also reminded him that HE had chosen to not vaccinate the pet and to not tell me that.)

So, what is the point of all of this? There are a few....

1) Allow the ER doctor (or any doctor) to perform the needed testing, and treatment so he or she may properly diagnose and treat your pet. That is usually the cheapest route in the long run.

2) Fresh testing collected near the time of the symptoms is the best chance to see what is really happening.

3) If you know something in the history that may be important, TELL the doctor, even if it may seem embarrassing. The doctor uses all available information to determine the diagnosis and the correct treatment. Your data is part of that information.

Working together as a team, you, your DVM, and the ER doctors provide a great chance of keeping your good friend running!

Why is it that sometimes a very severe problem is almost a non-event and sometimes what should be a minor "bump" becomes a true disaster?

I believe that it mostly has to do with preparation.

If you have prepared for a possible problem and have even a rough idea of how you will handle it, you stand a decent chance to do ok when it occurs. If you are what I call "fat, dumb, and happy," and are rolling along without any thought of "what if, " a small problem could become huge. And this applies to our pets, of course.

Doing a few simple things to prepare for problems will go a long way towards protecting our beloved friends from severe disaster.

Some examples:

Have a pet GO KIT in the event you have to evacuate. This could include proof of vaccination, a several day supply of medicine, special foods, necessary carriers, etc. Now in the event of hurricane, fire, etc., you simply grab the GO KIT and the pet and off you go.

Have a first aid kit for pets available. A commercial one could be acceptable, but you may want to include a muzzle in case your hurt pet is trying to bite. I would definitely include a Pet Emergency Clinic magnet for easy phone reference too.

Avoid situations that you KNOW increase your pet's risk of disaster. For example, allowing your dog to run loose, not using heartworm prevention, heavy exercise in the summer heat, feeding lots of scraps, not vaccinating, etc. etc. could be avoided and your pet will do better.

And many many more.This piece is not in any way meant to be exhaustive. Rather, it is to get you thinking about how you can be ready for problems.

Just a little thought ahead of time will nip most problems in the bud. It will put you at cause over the problem, and that is where you want to be.

Every week at ER, we see a few pets who were having real problems at home, but look normal by the time they arrive at the ER. Many of these owners are actually embarrassed and some are tempted to just take the pet home without treatment.

What is up with this? Why does it happen? Is the pet in fact magically cured by clinic air?

Believe it or not, this is very common and we do not think the owners are CRAZY when this occurs. Symptoms occur at home in the normal home environment. These symptoms are REAL indicators of a potential problem. The pet arrives at the ER, shoots adrenaline and distraction into his system, and, suddenly, he LOOKS normal.

Is he really CURED just because he looks normal at the clinic? Doubtful! There is still something wrong, but it is just masked by all the excitement.

Some owners in this situation decline even very simple testing offered in an attempt to diagnose the problem. This is not the best idea, since whatever caused the problem has definitely NOT just gone away. It is still there. Why not figure it out while it may still be early?

Some owners suggest that they will get needed testing at their day clinic, 12-48 hours after the symptoms occur. If they really do in fact do this, the results may not be as helpful, with testing being conducted farther away from the incident. Get the testing close to the incident to get the best benefit from the testing.

So, what am I telling you this week?

If your pet is ill enough to cause you to take it to the ER clinic after hours, chances are that something unusual IS going on and we SHOULD figure out what it is. NOW is the chance to do so, before it gets really bad.

We at ER would never consider you to be crazy if your pet's symptoms seem to disappear at your visit.

Handling pet problems as they occur is often the most efficient and cost-effective way to operate. When your ER doctor suggests a treatment plan, he/she is providing what he/she believes is the BEST course of action for your pet.

Following the recommendations of your ER clinician is the best way to get your pet better soonest!

2- Walk your pet dog frequently. This will reduce many behavior problems greatly. (Not sure how you walk a cat)

3- Keep all preventive care recommended by your DVM IN IN IN. Indoors pets have their own sets of problems associated with their more sedentary lifestyle, just as we may. Your DVM will recommend optimum care for such pets.

The stereotypes do not always apply, but they give you an idea.

So, which type of pet is best? Indoors or Outdoors?

The answer??????? (drum rolllllllllllllllllll)

It DEPENDS!

Each type of pet has its benefits and challenges. It boils down to personal preference and your lifestyle.

Outdoors pets are often better exercised and less prone to obesity, but more prone to trauma, infectious disease, and envirinmental problems.

Indoors pets are protected from the environment, but more prone to conditions we associate with a sedentary lifestyle, such as diabetes, Cushings disease, kidney disease, etc..

Clyde and I had been friends for the past 15 years or so. He had shown up at my day clinic, Companion Animal Hospital, as an uncowed, penniless teenager with no awareness of being "broke."

He amused my veterinary staff with multiple practical jokes always performed with fun and humor in his heart. He was to have been another one of the many who, in the past, I had taken in, patched up and fattened up for a few months, and then moved on to a a permanent home.

Problem was, at the time, I was dating and falling in love with my now-wife, Juliet, who did not understand the idea of helping homeless waifs and then moving them on to permanent digs. She just didn't get it. (And she still doesn't.)

So Clyde, who was a very formal dresser, always being seen in a tuxedo, came to break the tradition of staying a few months and then moving on. All because of Juliet, Clyde became the FIRST permanent Companion Animal Hospital kitty.

During this time, we came to love this massive black and white kitty. Clyde loved Science Diet so much that he would open brand new bags when I was not looking, despite having his own perpetually-full bowl available at all times.

When Clyde's new "brother", Mini Clyde, came into the fold, Clyde was philosophical and helpful. He eventually trained Mini Clyde, who looked like an overweight dwarf version of the original, to be almost as cool as Clyde was.

The third "brother", Doolittle, was not quite as big a success in the good manners department, but he is still with us today and remains a wonderful, if opinionated, fellow.

But back to Clyde and his many accomplishments....Clyde was a columnist, writing the famous "CLYDE'S CORNER" in my former newsletter. His dry wit and cool sense of elegance contrasted with my less elegant writing style.

Clyde starred on many of the clinic T shirts and even a video that we created for a contest to win an exam room remodel. Additionally, he stole the show in a feature newspaper article about Companion Animal Hospital.

To summarize, Clyde was a STAR for his at least 16 years of life.

When Companion Animal Hospital became Pet Emergency Clinic, Clyde and his "brothers" moved into our home and joined a few other felines in a sort of insane feline Brady Bunch with everybody being mostly happy most of the time.

Recently, Clyde began to lose weight and appetite, though not his awareness or personality. I delayed really checking him, not necessarily wanting to really know just what was up.

Finally, I decided that he must be checked and learned that his chest and abdomen were ravaged by cancer. Juliet and I lost our very good friend Clyde.

At painful times like this, I have to remember my own advice that I have given so many times over 30 years: THE PLEASURE AND FUN AND LOVE THAT WE RECEIVE FROM OUR PETS FAR OUTWEIGHS THE PAIN AND LOSS WE FEEL WHEN THEY ARE GONE.